John McCain struggles to talk about birth control
guest column

By Nancy Bennett of Portland, Oregon. Nancy is the political director for Planned Parenthood Advocates of Oregon.

Why is Sen. John McCain so uncomfortable?

Last week, Sen. McCain struggled to answer a basic question: did he have an opinion on whether it was unfair that health insurance companies cover Viagra, but not birth control.

It was the perfect opportunity for Sen. McCain to follow through on his pledge to court Hillary voters and show that he cares about the health care needs of women. But, he blew it. He stammered and squirmed and ultimately dodged the question. Most importantly, he revealed his utter lack of knowledge and interest on a question of basic fairness for women.

On Wednesday, Planned Parenthood Action Fund, the political arm of the national federation, launched a new TV ad, highlighting Sen. John McCain's answer on coverage for birth control. The TV ad is part of the Planned Parenthood Action Fund’s “kNOw McCain” campaign to educate voters about John McCain’s anti-choice and anti-women's health care record.

Watch the new ad:

Here is a bit more of Sen. McCain's record on birth control. In the U.S. Senate, McCain has twice voted NO on contraceptive equity.

In 2003, McCain voted NO on the Murray/Reid Amendment (S.Amdt 258 to S. 3, vote 45, 3/11/03), which would have improved the availability of contraceptives for women and required insurance coverage of prescription birth control if the insurance companies covered other prescriptions.

In 2005, McCain voted NO on the Clinton/Reid amendment to FY’06 Budget Resolution (S. Amdt 244 to S.Con.Res.18, 3/17/05). It included a requirement for contraceptive equity in health insurance plans.

July 17, 2008 | guest column | Comments (82 so far)
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Posted by: Katy | Jul 17, 2008 11:47:29 AM

This viagra v birth control coverage issue has pissed me off for so many years.
They played the audio of this on NPR the other day, what an out of touch goofball he is.

Posted by: Katy | Jul 17, 2008 11:50:42 AM

This viagra v birth control coverage issue has pissed me off for so many years.
They played the audio of this on NPR the other day, what an out of touch goofball he is.

Posted by: Katy | Jul 17, 2008 11:51:30 AM

See, I feel so strongly about this I felt I needed to make my point twice!

Posted by: RichW | Jul 17, 2008 12:05:09 PM

Those HRC "PUMA" supporters who are truly progressive (a group set that may not really exist)need to watch and read this over and over and over.

It is time to focus on the issue that will make or break progressive goals for the next generation. Who do you want to select th next two or three Supreme Court Justices. To me, the answer is clear - Obama, warts and all!

Posted by: joel dan walls | Jul 17, 2008 12:36:48 PM

PUMA seems to be about several things:

1) Anger at perceived misogyny, of which HRC was the target.
2) Anger at Democratic Party power brokers.
3) The opinion that Obama is an empty suit and a manipulative liar.

Arguments about the Supreme Court are irrelevant to the folks so motivated.

Posted by: Jack Roberts | Jul 17, 2008 12:52:33 PM

Actually, McCain gave a perfectly reasonable answer. If you really want a laugh, why don't some of you try to give an intelligent answer to the question explaining what coverage of viagra has to do with coverage for birth control.

(And, no, that doesn't mean I'm opposed to requiring insurance policies to cover birth control. It's just that viagra is a treatment for a medical disorder, and the birth control is a preventative measure for a natural medical condition. If insurance companies covered male prophylactics but not women's birth control, there would be an analogy, but not to viagra.)

Posted by: Katy | Jul 17, 2008 1:12:59 PM

Mr. Roberts:
This is a "perfectly reasonable answer?"
Q: Earlier this week Carly Fiorina was meeting with a bunch of reporters and talked about it being unfair that insurance companies cover Viagra but not birth control. And -

McCain: I certainly do not want to discuss that issue. (uneasy laughter)

Q: But apparently you’ve voted against (McCain laughter continues)

McCain: I don’t know what I voted -

Q: Voted against coverage of birth control, forcing health insurance companies to cover birth control in the past. Is that still your position?

McCain: I’ll look at my voting record on it, but I have, uh, (5 second pause) , I don’t recall the vote right now. But I’ll be glad to look at it and get back to you as to why, I don’t -

Q: I guess her statement was that it was unfair that health insurance companies cover Viagra but not birth control. Do you have an opinion on that?

McCain: (after 8 second pause) I don’t know enough about it to give you an informed answer because I don’t recall the vote, I’ve cast thousands of votes in the Senate. I will respond to - it’s a, it’s a (nervous)

McCain’s stumbling answer is reminiscent of when he was asked in March 2007 about public funding for contraceptives and he could only reply, “whether I support government funding for them or not, I don’t know.”

Of course many see the connection here that insurance companies have no problem making sure men can get it up but don't want to help women prevent an unwanted pregnancy. So the men should be covered so they can get some while the women are stuck paying for the outcome of said getting some. Hmm...just doesn't really seem fair? And of course the Rs don't want to cover birth control for women and also are against a woman's right to choose. So we have to pay for our birth control and if we can't afford to do so and end up getting pregnant Rs don't want us to have an abortion either.
But women aren't really supposed to have sex unless they're married so I guess it all works out in the end!

Posted by: oregonian37 | Jul 17, 2008 1:32:50 PM

A High 5 to Katy for that one. Well put.

Posted by: Jack Roberts | Jul 17, 2008 1:34:59 PM

Katy, you proved my point. A medical dysfunction doesn't stop becoming a medical dysfunction because it has to do with sex. After all, treatment for venereal disease has long been covered without unwarranted moralizing about or politicizing of that fact.

Whether contraceptives should be covered by health insurance has a lot more to do with debates over what insurance is designed to cover, not the sexual conduct of men and women.

Posted by: Katy | Jul 17, 2008 2:04:54 PM

Mr. Roberts,
I thought your point was; "what coverage of viagra has to do with coverage for birth control?"

...and I thought I gave you an answer to that. You seem to think the two are mutually exclusive while I do not.

Posted by: Kevin | Jul 17, 2008 2:09:01 PM

Of course many see the connection here that insurance companies have no problem making sure men can get it up but don't want to help women prevent an unwanted pregnancy. So the men should be covered so they can get some while the women are stuck paying for the outcome of said getting some. Hmm...just doesn't really seem fair?

I agree that it doesn't seem fair. But it needs to be pointed out that not all insurance policies decline coverage for birth control while providing coverage for E.D. meds. I changed jobs a little over a year ago and haven't checked to see what this newer policy covers. But I can tell you that my last policy (BlueCross/BlueShield) explicitly denied coverage for ED meds and did cover birth control pills.

I'm curious how many who object to E.D. meds being covered but B.C. pills not being covered also object to the reverse, as my last policy was structured?

Posted by: RichW | Jul 17, 2008 2:17:17 PM

"anger at perceived misogyny, of which HRC was the target."

Misplaced anger in my opinion.

So which is the greater misogyny? One perceived to be aimed at one woman running for Prez, or one that stacks the Supreme Court with judges that overturn women's rights in several areas including pro-choice and equal pay adjucations?

Listening to the rancor from the PUMAs, I have come to the conclusion that a few choose the group because their egos have been bruised beyond common sense while others may just be operatives for Limbaugh's Operation Chaos.

Having been an extreme lefty in my salad years, I observed many of my cohorts exhibit all sorts of misanthropic behavior, including spousal abuse and neglect - to me an abandonment of the social philosophy they are suposed to champion. Again egoism supplants the common good.

Posted by: Jenni Simonis | Jul 17, 2008 2:37:11 PM

What many men seem to misunderstand is that birth control pills aren't just about preventing pregnancies. They also level out hormone levels, which help to alleviate problems with cysts, help make PMS symptoms each month more bearable, etc. Some can cause an increase in the good form of cholesterol and decrease the bad kind of cholesterol. There are a number of health related issues that birth control takes care of that are outside of preventing pregnancies.

The number one reason I take birth control pills isn't to prevent pregnancies - it's to keep cysts from forming on my ovaries, which are extremely painful, can result in the need for surgery, and can cause internal bleeding.

Posted by: stephen kafoury | Jul 17, 2008 2:56:14 PM

Katy-
It's time for some linear, not political, thinking. You didn't carefully analyze Jack's argument. Asserting that an analogy exists doesn't make it so. Jack points out an analogous situation: male birth control and female birth control. Both are preventative measures. Another analogous situation would be providing Viagra for men and lubrication medication for women, responding to medical conditions and allowing each sex to engage in sexual activity. To equate a preventative measure with a curative measure just because you're angry about an insurance company's decision is not rational.
This is a totally separate issue from what insurance companies should be required to provide. Many arguments can be made supporting the proposition that coverage of birth control should be mandated. You have made some of them. However, false analogies, no matter how politically appealing, only make the presenter's case appear weak.

Posted by: Katy | Jul 17, 2008 3:04:29 PM

I don't know how to respond because I'm such an irrational female.

Posted by: UJ | Jul 17, 2008 3:15:40 PM

Thank you Jenni. I was wondering if that was going to come up. The first time I got BC in high school was to help clear up my skin. Now I take it because my hormone levels without it are so crazy and my doctor said it's the easiest way to control all the fun symptoms that go along with completely irregular menstrual cycles. It's also been shown to improve bone density and help prevent osteoporosis, help relieve symptoms of menopause, and prevent pelvic inflammatory disease. But those are all women's problems right? So why should insurance companies cover BC when it only helps women?

It seems completely clear to me that providing insurance coverage for men's problems while completely ignoring women's is just sexism on its face. When it's a man's problem, like ED, it's a "legitimate medical condition" but if a medical concern relates to women it's not? Right..

This issue is inextricably tied to women's reproductive rights as a whole, which is itself a crucial component of women's overall health and well being. To ignore that is just to say that women's health needs and concerns are not legitimate.

Posted by: UJ | Jul 17, 2008 3:25:47 PM

Yikes, I posted that after SK's post. Yes Katy, you are far too irrational to reply to that post. :) I am too but I'll give it a shot anyway.

To address this whole 'false analogy' problem. Yes, Viagra is not exactly the same as birth control pills. And in a simple world in a vacuum, that would be that. However talking about the difference in insurance coverage for men's health problems vs. women's, then we get more to the issue that I believe inspires so much rage from us crazy women-folk. Of course we could have an easier example if there was a comparable pill for women's sexual dysfunction, but they would actually have to research the issue and have a ladies' viagra (and hey, it's all just a bunch of frigid lesbians anyway! There couldn't possibly be any 'legitimate medical condition' causing female sexual dysfunction!). Which goes back to this issue of treating men's and women's health concerns as equally legitimate. Women's health concerns have historically not been treated equally or as deserving of attention by the medical community or insurance companies. That is the issue. This viagra vs. BC debate is part of this overarching problem.

Posted by: Marshall Collins | Jul 17, 2008 3:27:31 PM

So if preventative vs. curative is the reason why Birth control isn't covered then why have all of my vaccines been paid for by insurance also, my insurance pays for the allergy medicines that I start taking 2 weeks to a month before I actually start having any symptoms as they are able to get a good build-up in my system before the allergy season starts.
These are all preventative things that my insurance was happy to pay for. Insuracne pays for all sorts of preventative health measures because they have realized that paying a little now is much better than paying a lot later. My allergy meds are much cheaper than the emergency room visit when I end up not being able to breathe and my eyes swell shut. Hell, they even realized that a family member of mines boob reduction would be cheaper to pay for now versus waiting and having to pay for the back surgery, neck surgery and months of physical therapy a few years later.

Also, kudos to Jenni for the great post on the other reasons for taking birth control. I have a good friend who started on the pill years before she was sexually active to help control her crazy periods. I have also had friends who take them to prevent ovarian cysts. The pill is so much more than just a prophylactic. It's just the crazies that are either a) not wanting to piss off their big money insurance donors or b)not wanting to piss off their 'moral majority' buddies that are positive that the more we educate and help women understand and protect themselves the more we are tearing apart the fabric of society that are holding up good legislation like this from being passed.
As for insurance companies covering viagra, that is a clear sign that they are mostly all controlled by old money grubbing men. Cause in all reality the last thing our country needs right now is more boners.

Posted by: stephen kafoury | Jul 17, 2008 3:33:09 PM

Katy-
Please don't try to prove my point. Playing the sex card is just as bad as playing the race card. Obviously irrationality is not sex-linked- lots of men get caught up making political, not rational, statements. By falling back on gender-based statements, "I'm just a female", you allow yourself to avoid facing the rational position put to you.

Posted by: UJ | Jul 17, 2008 3:34:26 PM

And, if I may add, this disparity in men's vs. women's health issues (especially in areas regarding our reproductive systems) is tied directly to the fact that women are supposed to be baby-makers. We don't have sex for fun and if we do we're whores and sluts and deserve any repercussions from our not-for-babymaking-slutitude. Men on the other hand, if they can't get it up, it's a medical emergency necessitating millions in research. People like John McCain buy into the idea that women shouldn't have choices in our reproductive lives, whether it be access to a safe and legal abortion, or access to birth control to prevent the need for an abortion, or hell, even access to affordable insurance and health care for children once we have them. ::my irrational woman-anger...it grows..::

Posted by: Jenni Simonis | Jul 17, 2008 3:41:34 PM

UJ:

You made both my mom (she's in Texas - I'm on the phone with her) laugh pretty hard. Another one of those things were it's so funny, but unfortunately pretty true.

Posted by: Katy | Jul 17, 2008 3:43:31 PM

Avoid facing the rational position put to you? But I don't think it is rational!

"The last thing our country needs right now is more boners" is about my favorite BO line this year.

Posted by: Jenni Simonis | Jul 17, 2008 4:01:28 PM

And just another reason why we need Obama in the White House instead of McCain:

Bush to move funds for reproductive health services and pregnancy prevention to pregnancy crisis centers. Never mind that these centers do not offer any health services other than pregnancy tests. Clinics like Planned Parenthood would also not be able to refuse hiring nurses who are against abortions and birth control.

Posted by: David English | Jul 17, 2008 4:03:04 PM

I think Jenni made a good point about their being multiple reasons for women taking birth control besides actually preventing pregnancy.

Many years ago I dated someone who had very bad cramps during her period. On one occasion it was so bad that I insisted taking her to the hospital. As a man, I can't fathom what she was going through, but I can have sympathy for her. She was eventually put on birth control to regulate her period. As I understand it (even as a guy I do) some women experience more pain then others during their period. If a doctor can prescribe birth control to help that, then it should be covered.

As to the video of McCain, it was pretty damn funny to watch him try to answer that question.

Posted by: Jenni Simonis | Jul 17, 2008 4:05:48 PM

David:

Yea, and you'd think men would want women to have less PMS. ; )

Posted by: Harry Kershner | Jul 17, 2008 4:11:22 PM

RichW said, "It is time to focus on the issue that will make or break progressive goals for the next generation. Who do you want to select th next two or three Supreme Court Justices. To me, the answer is clear - Obama, warts and all!"

If I made this kind of an argument about, say, slaughter and torture in the Middle East, as in, "It is time to focus on the issue that will make or break progressive goals for the next generation. Who do you want to select foreign policy?", I'd be declared a purity troll who only wants to talk about one issue.

Yes, Supreme Court nominees are important, but our unitary executive type of government should be of even greater concern to progressives, particularly as it impacts foreign policy. And on that issue, I choose Nader, warts and all.

Posted by: Kevin | Jul 17, 2008 4:29:12 PM

UJ: Of course we could have an easier example if there was a comparable pill for women's sexual dysfunction, but they would actually have to research the issue and have a ladies' viagra (and hey, it's all just a bunch of frigid lesbians anyway! There couldn't possibly be any 'legitimate medical condition' causing female sexual dysfunction!).

Actually, Stephen already supplied the most analagous comparison - lubrication.
Viagra doesn't increase/decrease desire. All it does is facilitate copulation. In fact, it doesn't cause an erection, it only facilitates maintaining one.

This is all common knowledge, of course. Or at least it's easy enough to learn if one wishes to. But somehow I don't think that it's actually important to discuss the larger issue here fairly or factually. Mostly because it's been had innumerable times and I'm seeing the same demarcation lines of "just give me mine and to hell with whether you get yours" (on BOTH sides) that I've seen so many times before.


Posted by: Dev | Jul 17, 2008 4:35:05 PM

Is there some logical reason why insurance companies should prioritize curative treatments above preventative measures? If not why does it even matter that Viagra is curative and birth control preventative?

An unplanned pregnancy obviously has a much greater personal, physical, financial and social impact than ED. Shouldn't this be the standard used to determine whether it is more logical to cover birth control than Viagra? And using this standard doesn’t it follow that many insurance companies (not in Oregon because we do have contraceptive equality laws on the books in large part thanks to Speaker Jeff Merkley and Senator Kate Brown) demonstrate a bias against the health needs of women?


Posted by: Katy | Jul 17, 2008 4:51:20 PM

I don't understand how there could even be an example that compares to pregnancy? Women are the only ones who get pregnant, am I wrong?

I think it was unfair that insurance companies didn't cover birth contrl before Viagra (late 90s) and it became even more glaringly ridiculous when insurance companies decided to cover Viagra when it was put on the market and yet still would not cover birth control. Of course nobody is saying it's the same thing, it just shines a light on the blatant sexism.
I would really like to see insurance companies covering all preventive medicines and programs so we wouldn't end up paying so much after the fact for diseases that could have been prevented in the first place.
I think Jenni brings up a good point that birth control is used for a variety of health issues, including contraception - but I think it should be covered regardless. I get a little uncomfortable with this argument because I worry it's kind of a way to say "well, there are some women who are using it for medical reasons and not moral ones." It's legal to use birth control and women should have full coverage for birth control no matter what the reason; cramps or contraception.

Posted by: Jenni Simonis | Jul 17, 2008 5:09:11 PM

Oh, even if it were for only pregnancy prevention, it should still be covered. It is a routinely prescribed FDA approved prescription. It's necessary for the prevention of a very costly medical issue - pregnancy.

I just get tired of the complaint that Viagra treats a condition while birth control prevents something, which means they shouldn't be compared.

Posted by: RichW | Jul 17, 2008 5:12:53 PM

Why not just take a wider, progressive view and say that a prescription is a prescription and should be covered under a single-payer, inclusive health plan. Some will say we can't afford it. But we can if we have a will to do so. (we "can't afford an Iraq War" but somehow we had a will to start it)

Will ther be corruption and mismanagement in such a system. Of course there will, but we can minimize it with proper oversight. What institution doesn't have its warts.

So there will be people who resent paying for BC pills, glasses, hearing aids, and even wheelchairs, because they themselves don't need them. So what!

I happen to work for a philanthropy that provides orthopedic care for children. The philanthropy has never ever billed a patient since its its inception 80-some years ago. It has been supported by men across the entire political spectrum (from FDR to Barry Goldwater). It can be done for the population as a whole if:

1) We have a will to do so for the common.
2) We get off the "whats in it for me" mindset.


Posted by: Kevin | Jul 17, 2008 6:18:10 PM

I just get tired of the complaint that Viagra treats a condition while birth control prevents something, which means they shouldn't be compared.

Whether they SHOULD be compared or not, it is a fundamentally flawed comparison which detracts from rather than adds to the discussion, IMHO.

Personally, I feel that Dev asked by far the most salient question in this thread:

Is there some logical reason why insurance companies should prioritize curative treatments above preventative measures?

To my mind there is no question but that prioritizing preventative measures, whatever they may be, is flat out fiscally prudent, and is arguably ethically prudent as well. Which is to say that in terms of medical ethics it seems to me that NOT prioritizing preventative measures is unethical because that denial potentially contributes rather directly to needless pain and suffering.

That this particular preventative measure involves S-E-X is at best a side issue and at worst is just a monumental wedge issue.

Posted by: Jenni Simonis | Jul 17, 2008 6:34:34 PM

I definitely think preventative treatment needs priority treatment - for too long it's been something available only to those with the best insurance plans. Of course that is ridiculous since preventative treatment is much cheaper than waiting until something happens. Not only is it cheaper to the insurance company, but also to society as a whole - people are more productive, less likely to be ill (and potentially pass it along to others), and the like.

But you also have to make sure that in prioritizing preventative treatment that you don't make curative treatments expensive or not available on the lower end plans.

It's a delicate balance to ensure that people have access to services that will help keep them healthy, but at the same time give them access to the treatments needed if something does happen. Even with preventative services, you're still going to have people who need treatment.

When we had Abby, we paid something like $100 for the hospital and $60 for all our prenatal visits (one payment made at the time of the positive test). So that was about $160 for:

• 9 months worth of prenatal visits, which were quite frequent since I was very ill and began contractions 2 weeks before having Abby

• an emergency c-section

• staying in the hospital for 4 days

On the same plan I paid:

• $30 for my ObGyn appointment

• $20/month for birth control

So I would pay $270 for my annual exam and 12 months of pills, or I could pay $160 for 9 months worth of medical care along with delivery costs.

It seems like it would be in their best interest to make the preventative treatment cheaper since it costs them a heck of a lot less than the alternative.

Posted by: Jenni Simonis | Jul 17, 2008 6:37:45 PM

And I should also say that yes, having this included in an inclusive single payer system would be great. However, even when we elect Obama and a stronger Democratic Congress, it's going to take some time to put together everything and get it implemented. In the meantime, how many women will have unplanned pregnancies because their insurance doesn't cover their birth control and they couldn't afford it?

With the new rule regarding funding reproductive health services and pregnancy prevention programs being suggested by the Bush Administration, getting those services through places like Planned Parenthood will become increasingly difficult.

Posted by: doretta | Jul 17, 2008 7:55:20 PM

It's just that viagra is a treatment for a medical disorder, and the birth control is a preventative measure for a natural medical condition.

So, Jack, I gather you are not a doctor, nor do you play one on TV?

Your definition of "natural" doesn't really hold up. ED is as "natural" as pregnancy and carries a lot less serious health risk than pregnancy does. For that matter, cancer is just as "natural" as pregnancy and, since it inevitably happens to everyone, death is the most natural condition of all.

As has been noted, birth control is very commonly prescribed for hormone control unrelated to preventing pregnancy. It's also true that ED is very often simply a result of changing hormone levels associated with aging.

As I understand it, insurance companies typically structure drug coverage around the drugs themselves irrespective of the condition for which they are prescribed. If a company covers Viagra but not birth control pills that means that a woman who has been prescribed birth control pills for debilitating pain will get nothing from her insurance but a man who is less able to perform sexually due to aging will be provided with benefits to reverse that.

That's not exactly consistent with your logic above, is it?

Posted by: Ten Bears | Jul 17, 2008 8:57:47 PM

No matter how many times this is explained the vast majority fail to understand, the anti-abortion “pro-life” movement is adamantly anti-contraception. They not only intend to take away a woman’s right to make decisions about her own body, but the choice of a couple, presumably heterosexual, as to when, or if, they are to have a child.

Truly animals, egg-sucking dogs, feral pigs. Who fuck their own daughters.

Posted by: doretta | Jul 17, 2008 11:26:07 PM

Whether they SHOULD be compared or not, it is a fundamentally flawed comparison which detracts from rather than adds to the discussion, IMHO.

I see that the people who find the comparison "fundamentally flawed" are all male. Just a coincidence, I'm sure.

Personally, I think it's a very illuminating comparison.

How else would we find out that so many men consider it perfectly "natural" for men to take drugs to ehance their sexual performance but "unnatural" for women to take drugs to control when they become pregnant? Somehow I would have thought that affecting the function of the human body with modern pharmaceuticals would be equally "unnatural" or "natural" regardless of the motivation. Silly me.

As for the "prevention" vs. "curative" argument, insurance companies routinely pay for a wide variety of preventive measures. Most of them have huge programs designed to encourage preventive measures. My diabetic spouse is constantly hounded by her insurance company to get tests (which they pay for) and take drugs (which they pay for) aimed at preventing a wide variety of potential consequences. Can anyone name any other drug that insurance companies refuse to pay for on the ground that it's merely "preventive"?

I loved the "more boners" line too but I laughed even harder at this one:

Jack points out an analogous situation: male birth control and female birth control.

Yes, that's the perfectly analogous situation because the medical consequences to a male of his not being able to access birth control are practically identical to the medical consequences to a female of her not being able to access birth control.

Oh dear, am I guilty now of "playing the sex card"?

Maybe it's time we start a discussion about "male privilege".

Posted by: Katy | Jul 18, 2008 7:52:44 AM

Doretta, My thoughts exactly regarding male and female birth control. No woman in her right mind would leave the birth control up to the male.

Posted by: Grant Schott | Jul 18, 2008 8:06:30 AM

I favor ins. companies covering birth control (although in some ways it would be nice to get ins. cos. out of the equation.)

However, we should be accurate with the "facts" we are using. I once heard on NPR, and later heard a pharmasist confirm, that hardly any ins. plans cover viagra, maybe 1 in a 100. If that's true then we should stop using this bogus comparison between viagra/birth control.

Posted by: Kevin | Jul 18, 2008 8:25:34 AM

I see that the people who find the comparison "fundamentally flawed" are all male. Just a coincidence, I'm sure.

Which, of course, cuts both ways and by the same exact logic.

Cut off your nose to spite your face as you see fit.

Posted by: Kevin | Jul 18, 2008 8:32:38 AM

However, we should be accurate with the "facts" we are using. I once heard on NPR, and later heard a pharmasist confirm, that hardly any ins. plans cover viagra, maybe 1 in a 100. If that's true then we should stop using this bogus comparison between viagra/birth control.

I agree, Grant. But it seems to me that the facts aren't considered relevant by some here.

The internets and back pages of magazines and newspapers are full of ads for Viagra and other E.D. meds via some website which has it's own pharmacist to legally dispense. How could those sites so clearly thrive if health insurance plans covering E.D. meds are as ubiquitious as we've been led to believe?

Posted by: Katy | Jul 18, 2008 8:36:06 AM

Grant, In 1998, within weeks of hitting the market, more than half of Viagra prescriptions were covered by insurance.
The reason some insurance companies are not willing to cover birth control is because some crazy right wing nut bags compare it to abortion (which is also still legal last time I checked).

I've said it many times and I'll say it again, if men were the ones who got pregnant, not only would abortion be 100% legal but insurance companies would be covering, and would have always covered, all of the their birth control costs.

Posted by: Katy | Jul 18, 2008 8:37:27 AM

And to Kevin, I don't see anyone on here saying that Viagra should not be covered by insurance, I only see folks saying so should birth control.

Posted by: Sal Peralta | Jul 18, 2008 8:50:33 AM

If insurance companies covered male prophylactics but not women's birth control, there would be an analogy, but not to viagra.)

Until men start giving birth, insurance coverage for male prophylactics are not analagous to coverage for the pill. Arguably, Viagra's most common use is as a recreational drug, not as a curative for actual dysfunction.

The idea that many insurance companies will cover a recreational drug for men -- costing other insured individuals roughly $1.9 billion in 2007 -- but will not cover birth control for women, is asinine.

Posted by: Katy | Jul 18, 2008 8:53:38 AM

Sal is exactly right - I think the point of bringing it up at all is to illustrate how ridiculous it is, not to say that it's the same thing.

Posted by: Kari Chisholm | Jul 18, 2008 8:57:00 AM

Wait just a minute, Jack Roberts.

You said: Actually, McCain gave a perfectly reasonable answer.

And then you argued:

Whether contraceptives should be covered by health insurance has a lot more to do with debates over what insurance is designed to cover, not the sexual conduct of men and women.

Your argument is a perfectly reasonable answer. I disagree, but it's logically constructed.

Here's the problem: John McCain didn't say that.

If John McCain had actually made the argument against requiring birth control coverage (either because it's not "what insurance is designed" for, or because he's morally opposed to birth control), that would be one thing.

But let's recap what he ACTUALLY said:

McCain: I certainly do not want to discuss that issue. (uneasy laughter)

Q: But apparently you’ve voted against (McCain laughter continues)

McCain: I don’t know what I voted -

Q: Voted against coverage of birth control, forcing health insurance companies to cover birth control in the past. Is that still your position?

McCain: I’ll look at my voting record on it, but I have, uh, (5 second pause) , I don’t recall the vote right now. But I’ll be glad to look at it and get back to you as to why, I don’t -

Q: I guess her statement was that it was unfair that health insurance companies cover Viagra but not birth control. Do you have an opinion on that?

McCain: (after 8 second pause) I don’t know enough about it to give you an informed answer because I don’t recall the vote, I’ve cast thousands of votes in the Senate. I will respond to - it’s a, it’s a...

It's not his position, it's the obvious cognitive dissonance (or perhaps early-onset dementia) that's going on there.

Posted by: Kevin | Jul 18, 2008 9:07:36 AM

Katy, 1998 was 10 years ago.

I've already mentioned that my previous prescription coverage explicitly denied coverage for Viagra but did offer coverage for birth control pills.

I just checked and my current plan (an New Jersey variant of BC/BS) also explicitly DENIES coverage for Viagra and DOES offer coverage for Ortho Tri-Cyclen (the only birth control pill I checked on).

I used my insurance provider's online search form and it did ask WHY the Ortho Tri-Cyclen was prescribed (for Birth Control or "Other"). I checked the box for birth control and it was covered explicitly as birth control.

As I said, 1998 was 10 years ago.

Posted by: Kevin | Jul 18, 2008 9:33:07 AM

I don't see anyone on here saying that Viagra should not be covered by insurance, I only see folks saying so should birth control.

We must be reading different sites.

The "the last thing our country needs right now is more boners" quip up-thread and the variety of approving comments it recieved undermines your claim.

What I see is folks saying how egregious it is that Viagra is allegedly covered but birth control isn't. That implies precisely nothing in the way of support for Viagra being covered.

Posted by: Katy | Jul 18, 2008 9:55:50 AM

Kevin - is 2005 good enough?

"A study on private insurance found that:
49% of large group health insurance plans do not routinely provide contraceptive coverage.
Though 97% of large group plans cover prescription drugs, a mere 33% cover oral contraceptives—the most popular method of reversible birth control among American women.
Only 15% of large group plans cover all five of the most common methods of reversible contraception: oral contraceptives, diaphragms, Depo Provera, IUDs, and Norplant.

Source: The Alan Guttmacher Institute, Uneven and Unequal, Insurance Coverage and Reproductive Health.
...
Many Insurance Plans Exclude Contraception While Covering Other Services

Additionally, it is estimated that over half of all prescriptions for Viagra, a male impotency drug, are covered by insurance."

You're serious about the boner comment? Hahha, I'm still laughing about it from yesterday!

Posted by: Jack Roberts | Jul 18, 2008 10:04:55 AM

Glad I could help stir up a lively discussion here.

When I said McCain gave a reasonable answer, I was talking about the video, where he said "I don't know enough about this to give an informed answer." I thought that was perfectly reasonable and is an answer I wish more politicians would use.

Without wishing to start a whole long debate about the purpose and function of insurance, my understanding has always been that the original purpose of insurance is for a group of people to pool their money to protect each of them from unanticipated risks.

Car insurance covers us if we have an accident. It doesn't pay for our gas or for our oil changes.

Health insurance has slowly morphed into an imperfct welfare system in which employers pay to provide most of us with a wide variety of our health care needs. It may be smart, it may even be cost effective, for health insurance to pay for birth control pills, but that has absolutely nothing to do with whether it pays for viagra.

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